Expert Bone, Joint, and Muscle Surgery Restoring Your Mobility
Living with chronic joint pain, recovering from a fracture, facing knee replacement surgery, or watching your active life slip away because your body won’t cooperate anymore, these musculoskeletal problems affect every aspect of daily life.
At Botshilu, our orthopaedic surgeons specialise in treating bones, joints, muscles, ligaments, and tendons, from sports injuries to arthritis, from fractures to joint replacements.
Experienced surgeons with modern equipment and comprehensive surgical capabilities provide expert care, restoring your mobility right here in your community
Our Orthopaedic Surgeons
Medical Disclaimer: This information is for educational purposes and does not replace professional medical advice. Please consult with a qualified cardiothoracic surgeon for diagnosis and treatment recommendations specific to your condition.
What Conditions Do Our Orthopaedic Surgeons Treat?
Orthopaedic surgery encompasses a vast range of musculoskeletal conditions affecting all ages.
Joint Arthritis & Degenerative Conditions
Osteoarthritis
Wear-and-tear arthritis causes cartilage (smooth covering on joint surfaces) to deteriorate gradually over the years. Without healthy cartilage cushioning bones, joints become painful, stiff, swollen, and progressively less functional. Osteoarthritis commonly affects the knees, hips, hands, spine, and sometimes the shoulders.
Hip Replacement (Total Hip Arthroplasty)
Removes diseased hip joint, replacing it with artificial components, a metal or ceramic ball replacing the femoral head, and a metal or plastic socket replacing the acetabulum.
Knee Replacement (Total Knee Arthroplasty)
Replaces damaged knee joint surfaces with metal and plastic components. Total knee replacement addresses severe arthritis throughout the knee. Partial knee replacement (unicompartmental) treats arthritis affecting only one knee compartment, preserving healthy tissue with faster recovery.
Shoulder Replacement
Less common than hip or knee replacement but highly effective for severe shoulder arthritis, fractures not reconstructible, or rotator cuff arthropathy. Total shoulder replacement or reverse shoulder replacement (for patients with non-functional rotator cuffs) dramatically improves pain and function.
Rheumatoid Arthritis
Autoimmune disease causing inflammation attacking joints, leading to pain, swelling, stiffness, and eventual joint destruction. Rheumatoid arthritis requires medical management by rheumatologists, but orthopaedic surgeons provide surgical treatment when joints are destroyed despite medical therapy, joint replacement, fusion for stability, or synovectomy removing inflamed tissue.
Sports Injuries
ACL (Anterior Cruciate Ligament) Tears
ACL tears are common sports injuries, particularly in football, rugby, netball, and basketball. The ACL stabilises the knee, preventing excessive forward movement of the tibia. When torn (usually from sudden direction changes, landing from jumps, or direct blows), the knee becomes unstable, giving way unexpectedly, particularly during sports or pivoting movements.
Meniscal Tears
Menisci are C-shaped cartilage cushions in the knee. Tears occur from sports injuries or degenerative changes. Symptoms include pain, catching or locking sensation, swelling, and sometimes inability to fully straighten the knee.
Rotator Cuff Tears
Four muscles (rotator cuff) surround the shoulder joint, enabling movement and stability. Tears occur from acute injury (falls, lifting heavy objects) or chronic degeneration (repeated overhead activities, aging). Symptoms include shoulder pain (particularly at night), weakness in raising the arm overhead, and limited motion.
Achilles Tendon Rupture
Complete rupture of the Achilles tendon (connecting calf muscles to heel) occurs during sports, typically felt as a sudden pop, like being kicked in the back of the leg. Walking becomes difficult; you cannot stand on tiptoes on the affected side.
Shoulder Dislocation & Instability
First-time shoulder dislocations are usually traumatic. Recurrent dislocations indicate shoulder instability; ligaments and structures stabilising the shoulder are damaged. Young athletes with recurrent instability often require arthroscopic shoulder stabilisation surgery, repairing damaged structures to prevent future dislocations.
Cartilage Injuries
Articular cartilage (smooth covering on joint surfaces) can be damaged by trauma or repetitive stress.
Whilst cartilage has limited healing capacity, procedures exist addressing cartilage defects, including microfracture (creating tiny holes in bone, stimulating healing response), osteochondral grafting (transplanting bone and cartilage plugs), or autologous chondrocyte implantation (harvesting, culturing, then reimplanting cartilage cells).
Fractures and Trauma
Simple Fractures
Minimally displaced fractures with good alignment often heal well with casting alone.
Displaced Fractures
When fracture fragments are significantly misaligned, surgery is necessary to restore anatomical alignment. Fracture fixation uses plates and screws, intramedullary rods (metal rods inserted inside long bones), external fixators (metal frames outside the body with pins through bone, used for severe fractures requiring staged treatment), or combinations of techniques.
Common Fractures
- Hip Fractures
- Wrist Fractures (Distal Radius)
- Ankle Fractures
- Femoral (Thighbone) Fractures
- Tibial (Shinbone) Fractures
- Clavicle (Collarbone) Fractures
- Open Fractures
- Non-Union and Mal-Union
Hand & Upper Extremity Conditions
Carpal Tunnel Syndrome
Compression of the median nerve at the wrist causes numbness and tingling in the thumb, index, middle, and half of the ring finger, hand clumsiness, weakness gripping objects, and nighttime symptoms (often waking people from sleep).
Trigger Finger
Tendon inflammation causes finger to catch or lock during bending, often releasing with a snap. Corticosteroid injections often help. Persistent trigger finger requires minor surgery releasing the constricting tissue.
Dupuytren's Contracture
Progressive thickening of tissue in palm causing fingers (particularly ring and little fingers) to bend toward palm, unable to fully straighten. When significantly affecting hand function, surgery releases the contracted tissue.
Hand Fractures
Fingers and hand bones are commonly fractured. Some fractures are stable and heal with splinting. Others, particularly involving joints or significantly displaced, require surgical fixation with wires, screws, or plates ensuring proper alignment and function.
Tennis Elbow (Lateral Epicondylitis) and Golfer's Elbow (Medial Epicondylitis):
Overuse injuries causing elbow pain from tendon inflammation. Most respond to rest, physiotherapy, bracing, and sometimes corticosteroid injections. Severe persistent cases might require surgical debridement of damaged tendon tissue.
Foot and Ankle Conditions
Bunions (Hallux Valgus)
Big toe deviates toward other toes creating a prominent bump on the foot’s inner side. Causes pain, difficulty fitting shoes, and sometimes arthritis. Conservative management includes wider shoes, padding, and orthotic devices. Painful bunions affecting quality of life require surgical correction realigning the toe and removing the bony prominence.
Plantar Fasciitis
Inflammation of thick tissue band on foot’s sole causes heel pain, worst with first steps in the morning. Most cases respond to stretching, orthotic devices, physiotherapy, and sometimes corticosteroid injections. Persistent cases might benefit from surgical release of the plantar fascia.
Achilles Tendinopathy
Chronic Achilles tendon degeneration from overuse causes pain and stiffness. Treatment includes activity modification, eccentric strengthening exercises, and sometimes surgical debridement removing degenerated tissue.
Ankle Instability
Recurrent ankle sprains indicate chronic instability from stretched or torn ligaments. Severe instability affecting daily function sometimes requires surgical reconstruction stabilising the ankle.
Spine Conditions
Degenerative Disc Disease
Spinal discs deteriorate with aging causing back pain, stiffness, and sometimes nerve compression radiating pain down legs (sciatica) or arms. Conservative treatment includes physiotherapy, pain medication, and activity modification. Surgery is reserved for severe cases, spinal fusion stabilising painful motion segments, or disc replacement preserving motion.
Spinal Stenosis
Narrowing of the spinal canal from arthritis, bone spurs, or thickened ligaments compresses the spinal cord or nerve roots. Symptoms include back pain, leg pain or weakness with walking (neurogenic claudication, improving with sitting or leaning forward), and sometimes bladder problems. Surgical decompression removes bone and ligament creating space for neural structures.
Scoliosis
Sideways curvature of the spine. Mild scoliosis in children is monitored. Progressive curves, particularly during growth spurts, might require bracing. Severe scoliosis (particularly curves over 40-50 degrees) sometimes needs surgical correction with spinal fusion and instrumentation straightening the spine.
Paediatric Orthopaedic Conditions
Developmental Dysplasia of the Hip (DDH)
Hip joint doesn’t develop properly in infancy. Early detection allows non-surgical treatment with special bracing. Late detection requires more complex treatment including surgery.
Clubfoot (Talipes Equinovarus)
Foot turned inward and downward at birth. The Ponseti method (serial casting and minor procedure) treats most clubfoot successfully. Untreated or severe cases require surgical correction.
Limb Deformities
Bow legs, knock knees, limb length discrepancies, and other deformities sometimes resolve with growth. Significant persistent deformities might require surgical correction with osteotomy (cutting and realigning bones) or guided growth (temporarily limiting growth on one side of bone to correct alignment).
Juvenile Idiopathic Arthritis
Chronic inflammatory arthritis in children requires coordinated care between paediatric rheumatologists and orthopaedic surgeons. Surgery addresses joint damage not responding to medical therapy.
Paediatric Fractures
Children’s bones are still growing with growth plates (areas of growing bone) that can be injured. Fractures near growth plates require careful treatment ensuring they don’t disrupt normal growth.
Other Orthopaedic Conditions
Bone Infections (Osteomyelitis)
Bone infections from bacteria require prolonged antibiotic treatment. Severe cases need surgical debridement removing infected tissue. Untreated bone infections can destroy bone and cause serious systemic illness.
Bone Tumours
Benign bone tumours (osteochondromas, bone cysts) might require surgical removal if causing symptoms. Malignant bone tumours (osteosarcoma, Ewing sarcoma) require coordinated treatment with oncologists including surgery, chemotherapy, and sometimes radiation therapy. Limb-salvage surgery with large tumour resections and reconstruction aims to preserve limbs whilst removing cancer.
Osteoporosis & Fragility Fractures
Weak bones from osteoporosis fracture easily from minimal trauma. Common fragility fractures include hip fractures, wrist fractures, and spine fractures. Treatment addresses both the fracture and underlying osteoporosis preventing future fractures.
Soft Tissue Tumours
Lumps in muscles or soft tissues might be benign (lipomas, ganglion cysts) or rarely malignant (soft tissue sarcomas). Concerning lumps require biopsy determining nature and appropriate treatment.
Understanding Orthopaedic Surgery
Orthopaedic surgery (also spelled orthopedic) is the medical specialty focused on the musculoskeletal system, bones, joints, ligaments, tendons, muscles, and nerves enabling movement. Orthopaedic surgeons are medical doctors who’ve completed medical school plus 5-6 years of intensive orthopaedic surgery training. They diagnose and treat musculoskeletal conditions both surgically and non-surgically. Many orthopaedic problems don’t require surgery.
The musculoskeletal system is your body’s structural framework and movement apparatus. Bones provide structure and protect internal organs. Joints (where bones meet) enable movement. Ligaments connect bones to bones, providing stability. Tendons connect muscles to bones, transmitting force and creating movement. Muscles generate force to move joints. Nerves control muscles and transmit sensation. When any component is injured, diseased, or degenerated, movement becomes painful, difficult, or impossible.
Orthopaedic conditions profoundly affect quality of life. Chronic knee pain prevents you from walking to the shops. Arthritic hands make simple tasks like opening jars or buttoning shirts agonising. Fractured bones require months of recovery, affecting work and independence. Torn ligaments end sports careers. Back pain makes every movement miserable. These aren’t minor inconveniences, they’re debilitating problems affecting work, leisure, sleep, mood, and basic daily function.
Many people endure orthopaedic problems for years, thinking surgery is their only option and fearing it, not realising conservative treatments exist, assuming pain is inevitable with aging, or believing orthopaedic surgery is only available at large hospitals in Pretoria. These misconceptions prevent people from seeking evaluation that could dramatically improve their lives.
Why Choose Botshilu for Orthopaedic Care
Orthopaedic surgery requires both diagnostic expertise recognising complex musculoskeletal problems and surgical skill performing procedures ranging from straightforward to highly complex.
Botshilu’s Orthopaedic Surgery department offers:
Experienced Orthopaedic Surgeons:
Our surgeons have completed full orthopaedic training at respected institutions, have years of experience treating diverse musculoskeletal conditions, perform hundreds of procedures annually maintaining surgical proficiency, and stay current with evolving orthopaedic techniques. When surgical precision determines outcomes, whether a joint replacement lasts 20 years or 10, whether a fracture heals properly or develops complications, experience matters profoundly.
Modern Surgical Facilities:
Orthopaedic surgery requires specialised equipment including orthopaedic operating tables allowing various patient positions, high-speed surgical drills and saws for bone work, arthroscopic equipment for minimally invasive joint surgery, image intensifiers (C-arms) providing X-ray guidance during surgery, comprehensive implant systems (plates, screws, rods, joint prostheses), and dedicated orthopaedic theatre staff trained in these specialised procedures. Our operating theatres are fully equipped for complex orthopaedic surgery.
Comprehensive Diagnostic Imaging:
Musculoskeletal diagnosis requires detailed imaging including digital X-rays showing bone detail, CT scans for complex fractures and surgical planning, MRI scans visualising soft tissues (ligaments, tendons, cartilage, muscles), and ultrasound for some tendon and soft tissue problems. All imaging is available on-site, feeding directly into surgical planning.
Trauma Capability:
Orthopaedic trauma from vehicle accidents, falls, sports injuries, or assaults requires urgent surgical intervention. Our orthopaedic surgeons are available 24/7 for emergency consultations and can perform urgent fracture repair, dislocation reduction, and other trauma surgery when needed. Time matters in orthopaedic trauma, delayed treatment can result in complications, prolonged recovery, or permanent disability.
Joint Replacement Expertise:
Our surgeons perform total hip replacements, total knee replacements, partial knee replacements (unicompartmental), shoulder replacements, and revision joint replacements (replacing failed previous replacements). Joint replacement transforms lives, patients who’ve lived with severe pain and disability for years experience dramatic improvement.
Sports Medicine and Arthroscopic Surgery:
Sports injuries and joint problems often benefit from minimally invasive arthroscopic surgery. Our surgeons perform arthroscopic knee surgery (meniscal repair, ACL reconstruction, cartilage procedures), arthroscopic shoulder surgery (rotator cuff repair, shoulder stabilisation), and other minimally invasive procedures. Arthroscopy means smaller incisions, less tissue damage, reduced pain, and faster recovery compared to traditional open surgery.
Paediatric Orthopaedics:
Children experience unique orthopaedic conditions requiring specialised expertise. Our surgeons have experience treating children including managing fractures in growing bones, developmental hip problems, limb deformities, clubfoot and other congenital conditions, scoliosis and spinal deformity, and sports injuries in young athletes.
Fracture Care:
From simple fractures managed with casting to complex fractures requiring surgical fixation with plates, screws, or rods, we provide comprehensive fracture care. Our surgeons determine which fractures heal well with casting alone and which require surgery for optimal outcomes.
Post-Operative Rehabilitation:
Orthopaedic surgery success depends not just on surgical technique but on rehabilitation. We work closely with physiotherapists ensuring comprehensive post-operative care. Rehabilitation programmes are tailored to your procedure, helping you regain strength, mobility, and function whilst protecting healing tissues.
Multidisciplinary Approach:
Complex cases benefit from team input. Our orthopaedic surgeons work with rheumatologists for inflammatory arthritis, pain specialists for chronic pain management, oncologists for bone tumours, and other specialists ensuring comprehensive coordinated care.
Your Orthopaedic Surgery Team
When you’re facing heart or chest surgery, you’re not just seeing one doctor, you’re being cared for by an entire team of specialists working together for your wellbeing.
Orthopaedic Surgeon
Your Orthopaedic Surgeon is a medical doctor who has completed medical school plus 5-6 years of orthopaedic surgery training. They’re registered with the Health Professions Council of South Africa as specialists. Many orthopaedic surgeons have subspecialty interests, some focus on trauma, others on joint replacement, sports medicine, spine, paediatric orthopaedics, or hand surgery.
Orthopaedic Theatre Nurses
Orthopaedic Theatre Nurses are specially trained in orthopaedic procedures. They understand complex anatomy, manage specialised instruments, assist with implant selection and sizing during surgery, and maintain sterile technique during lengthy procedures.
Anaesthetists
Anaesthetists provide anaesthesia for orthopaedic surgery. Many orthopaedic procedures use regional anaesthesia (spinal or epidural) numbing lower body whilst you remain awake, or general anaesthesia for upper extremity or longer procedures.
Physiotherapists
Physiotherapists are crucial members of the orthopaedic team. Pre-operative physiotherapy sometimes optimises function before surgery. Post-operative physiotherapy is essential for successful outcomes, teaching exercises, monitoring progress, and guiding safe return to activities.
Occupational Therapists
Occupational Therapists help patients adapt daily activities during recovery, recommend assistive devices, and support return to work after orthopaedic surgery.
Orthotists & Prosthetists
Orthotists and Prosthetists fabricate braces, splints, and prosthetic limbs when needed.
FAQ
Frequently Asked Questions
Common Concerns and Honest Answers
?" Orthopaedic surgery can be quite painful initially, you've had bones cut, joints opened, tissue disrupted. Modern pain management using multiple approaches (oral medications, regional anaesthesia, ice) controls pain, though you'll have discomfort particularly in the first few days. Pain gradually improves over weeks. Most patients describe it as "manageable with medication" rather than unbearable.
This depends entirely on the procedure. After arthroscopic knee surgery, you might walk normally within days to weeks. After hip or knee replacement, you'll use walking aids for 4-6 weeks, then transition to normal walking. After ankle or foot surgery, you might not bear weight for 6-12 weeks. Your surgeon provides specific timelines.
Desk jobs might be possible 2-6 weeks after many procedures. Manual labour requires longer, sometimes 3-6 months. Your specific job demands, procedure type, and recovery progress determine return-to-work timing.
Modern orthopaedic implants (plates, screws, joint replacements) are titanium or cobalt-chromium alloys. They sometimes trigger airport metal detectors. Carry a medical card or letter from your surgeon explaining your implants. Security scanners are safe for orthopaedic implants.
Modern hip and knee replacements reliably last 15-25 years or more. Some fail earlier; many last longer. Factors affecting longevity include your age (younger patients often outlive their implants), activity level (high-impact activities stress implants), body weight, and infection. If a joint replacement fails, revision surgery (replacing the failed components) is possible, though more complex than primary replacement.
Low-impact activities (walking, swimming, cycling, golf) are encouraged after joint replacement. High-impact activities (running, jumping sports, contact sports) risk damaging the implant and are generally discouraged. Discuss specific activities with your surgeon.
Sometimes despite technically successful surgery, symptoms don't improve as hoped, chronic pain persists, expected motion doesn't return, or complications develop. This is devastating but sometimes reality. Further treatment might include additional surgery, pain management, or accepting limitations. Your surgeon discusses realistic expectations before surgery.
Almost certainly. Orthopaedic surgery success depends enormously on rehabilitation. The surgery creates conditions for improvement, removing damaged tissue, aligning bones, repairing torn structures, but physiotherapy builds strength, restores motion, and translates surgical repair into functional improvement. Patients who don't do prescribed physiotherapy have worse outcomes.
All surgery carries risks, infection, blood clots, nerve or blood vessel damage, ongoing pain, stiffness, implant failure, and anaesthetic complications. Specific risks vary by procedure. Your surgeon discusses risks relevant to your specific surgery. Modern orthopaedic surgery is generally very safe, but complications can occur.
Age alone doesn't preclude surgery, your overall health matters more. Many 80-year-olds tolerate joint replacement excellently; some unhealthy 60-year-olds are poor surgical candidates. Your surgeon and anaesthetist assess your fitness for surgery based on your overall health, not just age.
?" For elective procedures (joint replacement for arthritis, rotator cuff repair), timing is somewhat flexible, you can delay if you wish to try more conservative treatment or simply aren't ready. But delaying has consequences, ongoing pain, progressive deconditioning, sometimes worsening of the condition making surgery more complex later. For fractures, ligament tears in young athletes, and some other conditions, delays worsen outcomes, these shouldn't be postponed.